Unusual presentation of neurobrucellosis in Jeddah, Kingdom of Saudi Arabia

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Figure 1
- MRI brain, axial cut, FLAIR, normal MRI of the brain.

Table 1

- Timeline.

Dates	Past medical history
	35 years old female patient not known to have any medical or psychiatric illness.
Current illness
May 2020	Patient started to have on and off headache, numbness of the left hand, blurred vision, night sweats.
08 June 2020	Patient presented to ER with psychiatric symptoms in form of behavioral changes, inappropriate speech. Patient was admitted under psychiatry department and was discharged in good condition after 3 days.
23 June 2020	The patient visited our neurology clinic for the first time where a detailed history and examination were made.
Physical examination
23 June 2020	within normal limits
Diagnostic evaluation
24 June 2020	Brucella antibody test in blood sample: positive for abortus and melitensis, CSF analysis: demonstrates Leukocytosis with predominant lymphocytosis.
28 June 2020	Diagnosis was made.
Initial treatment
28 June 2020	Rifampicin 600 mg OD, doxycycline 100 mg BID, and moxifloxacin 400 mg OD.
Ongoing treatment
06 August 2020	Moxifloxacin was administered for 6 weeks, then stopped, and continued on rifampicin and doxycycline for a total of 12 weeks with a frequent follow up with infectious disease and neurology clinics.
Final follow up
06 August 2020	Follow up spinal tap after one month reported normal cell count. Patient completed her antibiotic course for more 6 weeks with significant improvement.